But wait, is there a role for immunotherapy in metastatic TNBC? Keynote-119 randomized 622 patients with metastatic TNBC that progressed on one or two prior lines of therapy to either pembrolizumab or chemotherapy (eribulin, vinorelbine, capecitabine, gemcitabine). In the overall population, pembrolizumab did not prolong median overall survival (10 versus 11 months). In addition, there was no significant difference in survival among those with a combined positive score (CPS) of 1 or higher (11 versus 10 months, HR 0.86, p=0.073) or among those with a CPS of 10 or higher (13 versus 12 months, HR 0.78, p=0.057). A post hoc analysis of a small subset of patients with CPS 20 or higher saw more divergence in survival (15 versus 12.5 months), which may suggest that a select subset of TNBC patients could benefit from immunotherapy. | Winer, Lancet Oncol 2021


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